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treatment & management

Drug Profiles:
lisinopril

AKA Prinivil®, Zestril®

CAUTION: Federal law prohibits dispensing without prescription.

   
Description
Lisinopril belongs to the class of medicines called angiotensin converting enzyme inhibitor (ACE inhibitors). It is primarily used to treat high blood pressure (hypertension) and certain coronary conditions. ACE inhibitors are also being successfully used as Migraine preventive medications.

Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For lisinopril, the following should be considered:

Allergies-
Tell your doctor if you have ever had any unusual or allergic reaction to benazepril, captopril, cilazapril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, or trandolapril. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy-
FDA pregnancy category D.
This means that lisinopril is known to harm an unborn baby. When used during the second and third trimesters of pregnancy, lisinopril can cause injury and even death to the developing fetus. Do not take lisinopril if you are pregnant.

Breast-feeding-
It is not known whether lisinopril passes into breast milk, and its effects on a nursing baby are not known. Do not take lisinopril without first talking to your doctor if you are breast-feeding a baby.

Children-
Children may be especially sensitive to the blood pressure–lowering effect of ACE inhibitors. This may increase the chance of side effects or other problems during treatment. Therefore, it is especially important that you discuss with the child's doctor the good that this medicine may do as well as the risks of using it.

Older adults-
This medicine has been tested in a limited number of patients 65 years of age or older and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines-
Always tell your doctor all medications you are taking, both prescription and over-the-counter. Before taking lisinopril, tell your doctor if you take or use:

  • lithium (Lithobid, Eskalith, others)
  • indomethacin (Indocin)
  • a potassium supplement such as K-Dur, Klor-Con, and others
  • any of the diuretics (water pills) triamterene (Dyrenium, Maxzide, Dyazide), spironolactone (Aldactone), or amiloride (Midamor) spironolactone (Aldactone), or triamterene (Dyrenium, Dyazide, Maxzide)
  • any other diuretic (water pill) such as hydrochlorothiazide (HCTZ, HydroDiuril, others), furosemide (Lasix), bumetanide (Bumex), indapamide (Lozol), and others
  • use a salt substitute that contains potassium
Lisinopril can affect potassium levels in the body. You may not be able to take lisinopril, or you may require a dosage adjustment or special monitoring if you are taking any of the products listed above.

Other medical problems-
Make sure you tell your doctor if you have any other medical problems, especially:

  • Kidney disease or kidney transplant
  • Heart or blood vessel disease
  • Liver disease
  • Systemic lupus erythematosus
  • Diabetes
  • are on a salt-restricted diet or have high levels of potassium in your blood
  • Dehydration

Proper Use of This Medicine-

  • Take lisinopril exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
  • Take each dose with a full glass (8 ounces) of water.
  • Lisinopril can be taken with or without food.
  • Do not stop taking lisinopril without first talking to your doctor.

Dosing-
The dose of lisinopril will be different for different patients. Follow your doctor's orders or the directions on the label. The number of tablets that you take depends on the strength of the medicine.

Missed dose-
If you miss a dose of this medicine, take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication.  

Storage-

  • Keep out of the reach of children, since overdose may be very dangerous in children.
  • Store away from heat and direct light.
  • Do not store in the bathroom medicine cabinet, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
  • Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

  • It is important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.
  • Use caution when driving, operating machinery, or performing other hazardous activities. Lisinopril may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities and notify your doctor. Also use caution when rising from a sitting or lying position.
  • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking lisinopril. Alcohol may further lower blood pressure and increase drowsiness and dizziness when you are taking lisinopril.
  • Do not use salt substitutes or potassium supplements while taking lisinopril except under the supervision of your doctor.
  • Heavy sweating, vomiting, diarrhea, or other causes of fluid loss may lead to very low blood pressure, dizziness, and fainting during therapy with lisinopril. Maintain proper fluid intake to prevent dehydration and related side effects.
  • Before you have any medical tests, tell the doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.
  • Check with your doctor right away if you become sick while taking this medicine, especially with severe or continuing nausea and vomiting or diarrhea. These conditions may cause you to lose too much water and lead to low blood pressure.
  • Dizziness, lightheadedness, or fainting also may occur if you exercise or if the weather is hot. Heavy sweating can cause loss of too much water and result in low blood pressure. Use extra care during exercise or hot weather.
  • Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are taking this medicine.

Side Effects of This Medicine

If you experience any of the following serious side effects, stop taking lisinopril and call your doctor immediately or seek emergency medical treatment:

  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives)
  • an irregular heartbeat or changes in your heartbeat
  • chest pain
  • sever dizziness or fainting
  • little or no urine
  • difficulty breathing
  • signs of infection including sore throat and/or fever

Other side effects are less serious. Continue to take lisinopril and talk to your doctor if you experience:

  • headache
  • mild dizziness or lightheadedness
  • unusual fatigue or weakness
  • dry, tickling cough
  • numbness or tingling in the hands, feet, arms, or legs
  • diarrhea, vomiting, or nausea
  • muscle cramps
  • rash
  • impotence

Some commonly used brand names are:

In the U.S. and Canada

  • Prinivil
  • Zestril
 
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Information offered at this Web site by either a lay person or a health professional should not be interpreted as giving a diagnosis or a treatment recommendation. These can only be provided by a physician who has had an opportunity to interact with a patient in person and at length, with access to the patient's previous records and appropriate follow-up.